BACKGROUND AND PURPOSE:

• Data unclear whether decreased mortality risk associated with coffee is modified based on addition of sweeteners or sugar
• Liu et al. (Ann Intern Med, 2022) evaluated the association of consumption of sugar-sweetened, artificially sweetened, and unsweetened coffee with all-cause and cause-specific mortality

METHODS:

• Prospective cohort study
• Participants
  • Adults in the UK Biobank
  • Without cardiovascular disease (CVD) or cancer at baseline
• Exposures
  • Consumption of sugar-sweetened, artificially sweetened, and unsweetened coffee
• Study design
  • Baseline demographic, lifestyle, and dietary data derived from the Biobank
  • Follow-up between 2009 to 2018
  • Cox proportional hazards regression was used to estimate hazard ratios (HRs)
  • Adjustments made for lifestyle, sociodemographic, and clinical factors
• Primary outcome
  • All-cause mortality
  • Cancer-related mortality
  • CVD-related mortality

RESULTS:

• 171,616 participants
  • Mean age: 55.6 years
  • Median follow-up: 7.0 years
  • Total deaths: 3177
    • Cancer-related deaths: 1725
    • CVD-related deaths: 628
• U-shaped associations for mortality risk were found for unsweetened coffee, sugar-sweetened coffee, and artificially sweetened coffee
• Unsweetened coffee was associated with lower risks for all-cause mortality
  • >0 to 1.5 drinks/day: aHR 0.79 (95% CI, 0.70 to 0.90)
  • >1.5 to 2.5 drinks/day: aHR 0.84 (95% CI, 0.74 to 0.95)
  • >2.5 to 3.5 drinks/day: aHR 0.71 (95% CI, 0.62 to 0.82)
  • >3.5 to 4.5 drinks/day: aHR 0.71 (95% CI, 0.60 to 0.84)
  • >4.5 drinks/day: aHR 0.77 (95% CI, 0.65 to 0.91)
• Sugar-sweetened coffee was also associated with a reduction of all-cause mortality risks 
  • >0 to 1.5 drinks/day: aHR 0.91 (95 % CI, 0.78 to 1.07)
  • >1.5 to 2.5 drinks/day: aHR 0.69 (95% CI, 0.57 to 0.84)
  • >2.5 to 3.5 drinks/day: aHR 0.72 (95% CI, 0.57 to 0.91)
  • >3.5 to 4.5 drinks/day: aHR 0.79 (95% CI, 0.60 to 1.06)
  • >4.5 drinks/day: aHR 1.05 (95% CI, 0.82 to 1.36)
• The association between artificially sweetened coffee and mortality was less consistent with wide CIs
• The association of coffee drinking with mortality from cancer and CVD was largely consistent with that with all-cause mortality
• U-shaped associations were also observed for instant, ground, and decaffeinated coffee

CONCLUSION:

• Consumption of moderate levels of unsweetened or sugar-sweetened coffee daily was associated with a reduced risk of mortality
• The authors state

Of note, many of the observed associations (including our findings) between high coffee consumption and morbidity and mortality are present with caffeinated as well as decaffeinated coffee, and thus it seems unlikely that caffeine alone can explain all potential health effects of coffee

Learn More – Primary Sources:

Association of Sugar-Sweetened, Artificially Sweetened, and Unsweetened Coffee Consumption With All-Cause and Cause-Specific Mortality: A Large Prospective Cohort Study

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